Recovering from Birth Control Podcast

Topics

News and updates from Diane [2:02]
1. Balanced Bites Spices
2. Balanced Bites Master Class
3. 21-Day Sugar Detox Daily Guide in Costco
Introducing our guest, Dr. Jolene Brighten [5:06]
Something Dr. Brighten is digging lately [7:38]
Post-birth control syndrome [11:52]
What is post-birth control syndrome [22:09]
What tests to run [32:50]
Side effect-free birth control [45:24]
Sleep disruptions and hormone balance [1:00:46]
Seed cycling for hormone balance [1:13:50]

The Pill Free Period: get back to normal after birth control

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You’re listening to the Balanced Bites podcast episode 347.

Diane Sanfilippo: Welcome to the Balanced Bites podcast. I’m Diane; a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo and the 21-Day Sugar Detox Daily Guide, which is now available in all US Costco stores. I live in San Francisco with my husband and fur kids.

I’m the co-creator of the Balanced Bites Master Class, opening soon for your enrollment, with my podcast partner in crime, Liz. Together, we’ve been bringing you this award-winning show for more than 6 years. We’re here to share our take on modern healthy living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; Liz, I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal.

The NTA’s nutritional therapy practitioner program and new fully online nutritional therapy consultant program empower graduates with the education and skills needed to launch a successful, fulfilling career in holistic nutrition. To learn lots more about the NTA’s nutritional therapy programs, go to http://www.NutritionalTherapy.com. Registration is open for their May NTP and NTC courses, so grab your seat today.

1. News and updates from Diane [2:02]

Diane Sanfilippo: Alright, guys. Before I get into my interview with Dr. Jolene Brighten, let me give you a couple of quick updates. If you have been waiting to grab your Balanced Bites spices, they are all back in stock right now. So head over to BBspices.com. They’re all available through Kasandrinos. Which is, as you all know, my good friend Tony and Effie Kasandrinos family company. They sell olive oil that’s imported from Greece. And they also have been so gracious as to help me fulfill orders for you guys for Balanced Bites spices. So I’m super excited about that.

I love seeing you guys post when you're getting them, how you're using them. It’s been super fun and it’s totally a passion project of mine that has been brewing since probably 2008 when I had my meal business, Balanced Bites back in the day. And I’m sharing a little bit more on tidbits and kind of backstory on all of that over on the @BalancedBites Instagram account for the spices. So be sure to check that out.

Also, you guys, the Balanced Bites Master Class is opening for enrollment in early June. So if you’ve heard us talk about it before, and you're curious if it’s for you, we will be talking a lot more about that in the coming weeks. But I do want to say the Master Class student track is primarily for those of you who are listening who are curious about diving deeper on nutrition who you want to sit down with myself and Liz; you know our voices. You're comfortable hearing them. And you know our perspective in general. But we haven’t always given you a true deep dive here on the podcast.

Because as you know, it’s tough to get into things in a one hour or a 30 to 40-minute show, when we really need to give you also more than just our voices. We need to give you some visual aids as well as worksheets and a workbook to kind of get through the information.

So if you're somebody who has been curious about becoming a nutrition consultant, or an NTP or an NTC. If you’re someone who just wants to learn more and deepen your understanding, deepen your knowledge, feel like you have a good grasp on how to explain why you eat the way you do to others. Or you just aren’t sure that you want to enroll in a $5-10,000 program with one of the nutrition schools out there, but this would give you that extra leg up to know; hey. I love learning more. And now I’m also going into another program knowing that I have a solid foundation, then this will be for you.

And keep in mind, if you do end up going on to complete one of the NTA programs; that’s the nutritional therapy association, who we talk about on this show all the time. You will be able to get CEUs for our class through the NTA. So keep that in mind. We’ll talk more about it on an upcoming episode, probably next week or the following week, for sure.

And as I mentioned in the intro today, the 21-Day Sugar Detox Daily Guide is at Costco in all US stores. If you don’t see it, please ask. Or check through the stacks. As you guys know, sometimes those stacks get a little bit messy, so you can kind of riffle through, move things around, and grab your copy right there. And I can’t wait to see how y’all do on the next sugar detox.

2. Introducing our guest, Dr. Jolene Brighten [5:06]

Diane Sanfilippo: Alright, you guys. I am super excited, because I’m bringing back Dr. Jolene Brighten. She is absolutely one of the most popular guests we’ve ever had on this show. You all have responded in; round of applause, standing ovation, I don’t know. Arsenio Hall, whoop, whoop. {laughs} Who remembers that from back in the day? But I feel like you all have been so excited about the past episodes that she was on, so I wanted to bring her on again. And talk about something that she’s super passionate about, as well; all on the female hormone tips.

So before I begin this interview, in case you did not hear those episodes, let me give a quick intro to Dr. Jolene. Dr. Jolene Brighten is a functional medicine naturopathic doctor, and the founder of Rubus Health. A women’s medicine clinic that specializes in women’s hormones. She is recognized as a leading expert in post-birth control syndrome, which we’re going to talk about today. And the long-term side effects associated with hormonal contraceptives.

Dr. Brighten is a best selling author, speaker, and regular contributor to several online publications, including Mind, Body, Green. And, she is a medical advisor for one of the first data driven apps to offer women personalized birth control recommendations. How cool is that?

Well I mentioned Dr. Jolene has been on the show before. You can check that out. We talked about, obviously female hormones episode 299, and self-love, adrenals, stress, and alcohol and hormones and birth control, so many great topics. It was the continuation of that conversation in episode 302. Do not miss those, you guys. If you listen today and you had not been listening, I guess it’s almost a year ago now that I spoke to Dr. Jolene last. You will absolutely love those episodes. Please go back and listen to them 100%.

Alright you guys, I’m going to jump into it with Dr. Jolene. You're back on the show! I think this is your third appearance on the Balanced Bites podcast?

Dr. Jolene Brighten: Third time! {laughs}

Diane Sanfilippo: Third time’s a charm. And it will definitely not be the last. Our listeners absolutely love your episodes. Which, also, totally self-indulgent for me. I love chatting with you. I love asking questions, as well. So yay, welcome back.

Dr. Jolene Brighten: Thanks for having me. And I love your listeners. You’ve done such a good job making sure that you have a super educated and empowered fan-base. I love their questions. I saw everything coming through on your social media, and I’m like; man! These women are on their game!

3. Something Dr. Brighten is digging lately [7:38]

Diane Sanfilippo: Yeah, they are. They’re on it. Well, before we get into more serious topics, you know we like to do little ice breaker, getting to know you things. So let’s talk about one thing that you're digging lately that’s either something new or something you’ve just gotten back into or something you're trying. And it can be nutrition related or lifestyle related. Any thing that’s kind overall health and wellness that you're digging lately.

Dr. Jolene Brighten: Yeah, I’m kind of obsessed with turmeric eggs. So this was kind of a lazy Sunday morning discovery for me. Where I threw butter in a pan. Some good grass-fed butter, ladies. And then grated turmeric into the pan, threw some eggs in, and just put a lid on it. The turmeric gets all crispy around the egg whites. And this is something that people have seen me posting on Instagram. But I’m so obsessed with this, because the butter.

And I have chickens; if you follow me on social media, you see my chickens. You probably caught the time I got locked in the chicken coop, when we got snowed in and the ice was covering and I couldn’t get out. So I was like; I’ll do an Instagram story. Hi.

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: I’m a Portlander. I’m trapped in a chicken coop.

Diane Sanfilippo: This is so typical.

Dr. Jolene Brighten: {laughs} And my family was out of town. I was like; am I going to have to call the fire department? What actually happens here in this situation? {laughs} I eventually got out. But turmeric eggs are the thing. I don’t know if anyone else is doing that, but that was just a discovery where I was feeling a little inflamed in the morning. I’m like, I need some turmeric but I really want to eat these eggs. And that’s how I discover most of my recipes. It’s like; what’s the laziest, simplest way to get this done?

Which everyone listening; you're probably going to eyeroll and be like; she don’t seem lazy! I see everything that she’s doing. But I’m all about; how do we get the least barrier to living a healthy lifestyle.

Diane Sanfilippo: Yeah. Efficiency. For sure. We were just joking about that before we hit record. About how we both consider ourselves lazy. And we know that everybody would kind of eyeroll, or laugh, or be like; wait, what? But yeah. It is mostly about efficiency, and mostly about knowing what we’re capable of, I think. And just, I had a couple of years there where I felt like I was not doing as much as I could have.

But, when you said it was a lazy way to make turmeric eggs, here I am picturing what would be lazy for me is that I cooked something with turmeric in, let’s say, a cast iron skillet and it’s just kind of left over in there. And then I discovered that cooking my eggs in there was magical. And then I would do it again on purpose the next time. But for me, unfortunately, that would become fishy eggs. Because I have salmon that I’ll cook in a cast iron skillet. And then my husband would be like; why didn’t you clean out the pan? Now my eggs taste like fish!

Dr. Jolene Brighten: And you're like; well, you can be grateful for the eggs. How about that? {laughs}

Diane Sanfilippo: I know. I know. It’s so funny. Awesome. I love that. That’s a cool idea. We actually had, I think it was about a pound of turmeric in the house several weeks ago when Scott tried to order turmeric from Instacart.

Dr. Jolene Brighten: Oh, that happened to me!

Diane Sanfilippo: And instead of one knob, it was like a giant amount. He was like; honey, I don’t know what to do with all of that. I can’t even juice all of it. What are we doing with all of this? I think it eventually got composted. Womp, womp. But next time. Turmeric eggs.

Dr. Jolene Brighten: I think it was Amazon Prime that it happened to me. But yeah, I opened up the bag and there was this giant amount. I actually shared some with my neighbors. And my kid will gnaw on turmeric. It’s crazy to me, but he’ll just grab it and put it in his mouth. But it was like, turmeric everywhere for everyone now.

Diane Sanfilippo: I love it.

Diane Sanfilippo: Today’s podcast is sponsored by Equip Foods. Dr. Anthony Gustin and his teams have created lines of supplements that are super clean and effective, no matter what your dietary needs. I’ve been blending Equip’s complete collagen into my matcha latte every morning. Each scoop has 15 grams of protein, and there are no added flavors. It’s a nice frothy texture to my matcha after it’s been blended in. Check out at www.EquipFoods.com and use the code BALANCED for 20% off everything on the site, as well as at their sister product site. Perfect Keto.

4. Post-birth control syndrome [11:52]

Diane Sanfilippo: Alright. So, we received so many questions for you. Which is super fun, and it actually gave us a bunch of ideas about ways to bring you back on the show in the future in some different ways. So now I’m planting that seed. But we have so many questions that we’re going to group some of them together, because we obviously have common themes. And maybe some different nuances to the questions as they come in.

And as I mentioned, Dr. Jolene has been on the show already. And we had tons of questions about things like testosterone levels. We touched on that in episode 302. Postpartum hormone recovery was another big one, so check out episode 299 for that one. And for those of you who are asking a lot about PCOS, we touched on that a bit in episode 302, but also in an older episode that I did with Stefani Ruper, episode 186.

So we are many years into this show, and we’ve talked about these topics many different times. You guys might want to check out those in the archives. Which you can always get to at www.blog.balancedbites.com. There’s a podcast archive by topic. Which some of you may not realize is extremely handy. You could just fall down a rabbit hole, and read transcripts. Listen to clips, whatever you want to do.

Ok. So, we’re going to start with post birth control recovery, because if any of you follow Dr. Jolene on Instagram. First of all; if you don’t, you need to. Because I love following you. I should say Dr. Brighten, but I can’t help but say Dr. Jolene. Anyway.

Dr. Jolene Brighten: Whatever. You're all good.

Diane Sanfilippo: Your behind the scenes; I love how you share little clips of your life. But also tons of education and step by step really informing us on what’s going on with our bodies. And linking to articles, and posts you're writing on the blog. So that’s really, really helpful.

But let’s start there. Because that’s really a place that you're focusing on lately, and deep diving into. So, let’s just kind of dig in on topics like how long does it take to recover from years of being on the pill? I was on it for about 10 years, solely to “help” with my period at the time. {laughs} So, when I went it for many years, it was for that purpose. How long does it take to recover? How do we start to regulate our cycles? Give us some background on that. And I’ll dig into some little sub questions maybe as you give us a little bit of a background.

Dr. Jolene Brighten: Yeah. So, what you brought up about how you were on it to “fix your periods.” I think the first thing women need to know is that it doesn’t actually fix our periods. Although, when I was on the pill; I did it 10 years, too. And I thought it was a godsend when I didn’t have to be bleeding for 7-plus days out of the month. My periods were so bad when I started that my doctors actually thought that I had endometriosis. But when you're a teenage girl, nobody wants to start doing exploratory surgery. Thank goodness for that. So glad for that.

As it turns out, I don’t have endometriosis. I just had incredibly painful periods. Which has to do more with my prostaglandins, estrogen dominance. Doctor me is like; oh, that’s what was going on. But the reality is almost 60% of us are on hormonal birth control for symptoms alone. And not actually for pregnancy prevention. Which is how these hormones were designed; to prevent pregnancy.

So I just want to say; I’m not anti-birth control in any way. I’m more pro informed consent. Making sure that you're in the know about how to take care of your body. And how to best support yourself, and make the best decision for yourself. Some women; most women don’t say, “I did the pill and things were fine.” Most of them have a pill story. But with things like IUDs, it really varies.

So what’s true for your mother, what’s true for your sister, what’s true for your friend, may not be true for you. And you’ve probably heard this; I definitely talked about this on Instagram that there’s a lot of really great health information that’s out there that’s very true. But is it true for you? And that’s what you have to understand.

Now, to your question of coming off of birth control and how long can we expect to recover; that really varies from person to person. Some of the factors that come into play is; why did you get on it in the first place? If you have something like PCOS or endometriosis, that’s going to be a lot more significant than a woman who never had period problems, only used this for pregnancy prevention.

So what I see clinically is that if you’ve never done anything to really address what these hormones have been doing, you're probably going to have some lingering effects. So every woman who has ever been on hormones needs to do some of the things we’re going to talk about today, I’m sure. But recovering your gut. Making sure you're resetting that microbiome.

And if we back up and think about; how do these hormones work? How they work, to prevent pregnancy, is they stop your brain and ovaries from talking to each other and functioning. So it’s something; I do an eyeroll, sometimes I laugh. Sometimes my husband knows I scream about it and I get really angry when doctors are dismissing women’s symptoms; saying, “Oh, no, no. There’s no way these hormones could cause that whatsoever.”

But if we stand back and think; this is a medication that’s strong enough to override your reproductive system. How can it not have some lasting effects? And, PS, research studies are looking at healthy women who go on these hormones. They’re not looking at women who have preexisting conditions, like autoimmune thyroid disease. Which is really common in women. Or adrenal issues. Or digestive issues, like celiac disease or Crohn’s disease. Even milder effects than that.

So that’s the other thing we have to frame. There are some flaws in the research. Your doctor is not a bad person, ok. They want to help you. Their toolkit is a little bit limited, and they don’t actually know all these things. I wasn’t taught all of these things in medical school, and I went to holistic. I went to naturopathic medical school. I studied clinical nutrition and nutritional biochemistry in my undergrad. I learned there about the nutrient-depleting effects of birth control. But I didn’t learn all these other things.

And it wasn’t until I lost my period after coming off the snap that I was like; oh snap! Somethings going on here! Because my doctors are saying; no. You probably have PCOS. No, you had irregular periods all along. I didn’t. That wasn’t true. There were moments though that I started to second guess myself. Like, maybe I am crazy. Maybe that are right. Maybe it was that way.

I didn’t really answer your question, though, about how long it takes to recover! {laughing} So let me answer that.

For some women, it can take 30 days of doing a protocol and focusing on these things to start to get back to your normal. For other women it can take 6 months or more. And if you’ve lost your period; what’s called post-pill amenorrhea. I have seen; it just depends on what was going on all along. I’ve had women that have had their period come back 10 months later. 10 years later. And I’ll say 10 years; that’s a little more of the outlier. That’s not the norm. But I did have a patient just a couple of months ago that after working together; we worked together for three years.

So understand, you didn’t get here overnight. You're not going to reverse all of this overnight. Especially like you and I, who did it for 10 years. That’s 10 years of saying; your brain, shush. Your ovaries; shush. And if you're shushing those systems, it’s going to affect other systems as well.

So that long-winded answer is basically to say; it depends on what’s going on. What’s your root cause? What is your lifestyle like? What is your genetics like? What is your family history like? There are a lot of things we have to consider. So with family history, let’s say you're a woman who is 37. You come off of the pill. You're not getting your period back, but your mom went into menopause at 40, genetically there might be something there going on. And this might be that we’re heading into primary ovarian insufficiency.

Now, take heart. Take a breath. If you're panicking about that, know that this used to be called premature ovarian failure. We’re not really calling it that anymore, because 10% of women spontaneously recover their fertility and become pregnant. Hey; if 10% of you can get your period back and spontaneously recover your fertility, without doing anything about it; what if you actually do something about it? That gives me hope. And I just want to make sure that women understand that there is hope in all of this.

But the first thing you’ve got to do is start figuring out what is going on with your body. And if your period has been gone for three months or more, it is time to figure it out. To get to that root cause. To start lab testing, and partnering with the doctor. Does that all make sense? Did I circle back and answer that? {laughs}

5. What is post-birth control syndrome [22:09]

Diane Sanfilippo: Yeah, totally. And one thing you brought up in what you were saying was that whatever the issues were and imbalances that were causing excessive pain or excessive bleeding. Anything that was happening was the reason that you asked to be put on the pill, or it was recommended that you were put on the pill. You mentioned something about; the pill obviously doesn’t fix that. It just kind of shuts off the communication from your brain to your ovaries. Does going on the pill kind of put those things on hold, but then they just come back when you go off. Or does it always reintroduce a whole set of other problems?

I feel like when I went off of it, I wasn’t aware of so many of these things. I just kind of knew at the time I didn’t want to be taking hormones in. I was probably at the very beginning of the journey that I’m, you know, over this last 10 years of learning about this and kind of understanding it more. So I just knew at the time; I don’t think I really want to be taking these hormones in. Even though I did still want those birth control benefits. I was like; I’ll find another way.

But I don’t know what happened while I was on it. I think it was making me a little depressed now and then. And I’m just curious. Do those old problems; whatever those imbalances are. Did they kind of go on hold, or no? Do they just come back later? Are we getting new problems as a result of actually disrupting that communication from the brain to the ovaries all that time?

Dr. Jolene Brighten: That’s a great question. So that really comes into what is post-birth control syndrome? Something I’ve heard a lot of people starting to say lately is; “Oh, you're only going to have post-birth control syndrome if you have symptoms before starting these hormones.” That’s not true. That’s not what we find clinically.

So yes, let’s say you went on hormones because you have acne. We can expect that to come back; and usually it comes back with a vengeance when you come off of these hormones. And it’s not because your body is betraying you. It’s because basically you’ve put duct tape over your mouth. So your body; that acne was your body’s way of talking to you. Saying; hey, we’ve got a deeper issue. Because your skin is benign compared to your heart, or your liver, or your lungs. These are very important organs. So your body is like; whatever, skin.

So what you basically do is you duct tape over your body’s mouth. Now, you stop these hormones, you rip the duct tape out, and your body starts screaming for help. It’s not that it’s betraying it, it’s that it’s trying to signal to you that it needs some attention. It needs some support. Because ultimately; I’ve just got to say, I really hate the story of; “Oh, your body is betraying you.” Or, “Oh, these symptoms are a problem.”

No! Why would your body do that? All your body wants you to do it survive. It’s in it for the long haul. It wants the best for you. So with that, with post-birth control syndrome, you can see your previous symptoms come back. But you can also see new symptoms. Part of post-birth control syndrome is the long-term side effects and consequences of using these hormones that don’t just go away because you quit them.

So things like nutrient depletion. So, here’s the deal. You had acne; now you're on a pill that’s depleting your nutrients like crazy. Now your zinc is low. Now your B vitamins are low. Forget liver detox with that, which is ultimately going to help your skin. And then you come off. And now you don’t have that suppression. And what you’ve got now is not enough of the good stuff that you need to actually handle that hormonal chaos.

And, in the acne case, we can see androgen rebound. So that is, your testosterone comes back online. And now we’ve got oily skin. We’ve got acne. And this is something I saw there were a lot of questions about acne, which is why I want to use this example and illustrate that. So it’s a situation where it just really depends. And when you stand back and understand that these hormonal contraceptives disrupt your gut. It disrupts your microbiome. It can lead to intestinal hyperpermeability or leaky gut.

PS; do we all remember when we were called crazy for saying leaky gut? Or do we all remember when adrenal fatigue was quackery? Oh my goodness! This is something I hear too, is that post-birth control syndrome can’t be real. Really, medicine? Can we have a little humility for the fact that the woman who is sitting in front of you is saying that she is having issues.

And PS, we are still discovering anatomical structures in the body. We don’t know everything. A study can’t show us everything. And I don’t care how many studies are out there; your patient is not lying. This woman is not lying. She’s the only one who knows what’s normal in her body.

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: I get all ranty.

Diane Sanfilippo: Whoo! Amen!

Dr. Jolene Brighten: I know! {laughing}

Diane Sanfilippo: Oh it’s so interesting. When you were talking about how taking the pill can disrupt your gut function. I was trying to think back to the combination of when I started changing my diet, and kind of getting off of gluten and just eating more healthfully in general. And I can’t tell exactly when that started and when I went off of the hormonal birth control. But I do know that indigestion I used to get all the time, upper GI issues and a lot of lower GI issues were kind of subsiding aw the same time. So now I’m like; I wonder how much of this was specific to the elimination was doing of the foods; or the removal of those hormones. So that’s just kind of interesting to think about. I won’t spend much time thinking about it, because that was so many years ago and I just can’t live there mentally. But it’s interesting to think about.

Dr. Jolene Brighten: But you make a really good point.

Diane Sanfilippo: Like, maybe going off the pill helped more than I thought.

Dr. Jolene Brighten: Yeah. The first food sensitivity panel I took was clear leaky gut. I had like 90 something foods I was reacting to, and my doctor was like; don’t eat those foods. I’m like; what, I like to eat!

Diane Sanfilippo: It’s a great solution. Thanks doc.

Dr. Jolene Brighten: Like, I’m a foodie! And this is something that I think is the definition of insanity; when doctors keep treating SIBO; small intestine bacterial overgrowth. Over and over and over. They’re pulling more and more foods out of your diet. I hate that! You know. We share a common ground. We’re foodies! My ancestral self would not have been avoiding all of these foods.

So when I see these things where it’s like; now you have more food sensitivities. You’re cutting more foods out of your diet. We’re going to treat SIBO again for the 10th time. Oh, you can’t clear that Candida, stay on the anti-Candida diet forever. But nobody is questioning; what is going on with the pill? What is going on with these hormones? And that’s something that, if your doctor is doing the same thing over and over, but expecting different results; it’s Albert Einstein who declared the definition of insanity. So that doesn’t come from me. That comes from a legit genius. {laughs} We can all agree on that.

So it’s just something we also have to look at. The other thing, too; how many of us are avoiding drinking out of plastic water bottles? How many of us are avoiding xenoestrogens? Cleaning up our skin care? By the way, these are all musts, if you are a human on this planet. Definitely do these things. But at the same time, why aren’t we questioning this known carcinogen. This environmental toxin that we’re putting into our bodies? The patch we’re placing. The NuvaRing that we’re inserting. Or the IUD that’s in our body. We still have to be questioning things.

I will also say, why we don’t see this being questioned enough, is because these hormones have been instrumental in women’s movement. We graduated college at higher rates than ever before once we had these hormonal contraceptives introduced. So I’ve definitely been called anti-feminist, anti-woman for questioning these things. But really, I think the new feminist movement is to question everything and make an informed decision for your body. And not just become complacent, and be like; well my doctor told me to do this thing.

Question me. Question you. Question everything. Figure it out for yourself. And you don’t have to be a doctor. You don’t have to have medical education. You don’t even have to have a certificate in nutrition to know how you're feeling in your body every single day.

Diane Sanfilippo: I can’t believe somebody would say that it’s anti-feminist just because you don’t want people to unknowingly destroy parts of their body by taking hormonal birth control. That has nothing to do with supporting or not supporting birth control methods as a whole. Which is really kind of the point behind the women’s movement. Now we can either delay and have a choice around having babies or not, and doing different types of work and all of that comes along with it. But I just find that so absurd to say, that you wouldn’t be feminist because you want people to know, or you think this is… Yeah. I can’t wrap my head around that statement! That’s crazy.

Dr. Jolene Brighten: You know, it’ lights people up, though. And I definitely can understand where it’s like; you’ve been told a story. You have a story that you're living in. And when I come out and say these things that disrupt your story; that’s going to light you up. Especially if you're like; wait a minute. But I got on these hormones. And it’s the only thing that seems to work for me. And I’m saying; yes, and there can be issues with that.

And really what I want; look. You want to do these hormones; fine. Can we get you the right lab testing? Can we monitor your individual biomarkers? Can we get you eating turmeric, and doing these things that are going to help your body through all of that? Because also, in some ways, it’s a privilege that we do have access to hormonal contraceptives. And we have so many choices when it comes to controlling our fertility. And I never want women to feel shamed in any way.

But I also recognize that I challenge dogma left and right. I hate dogma. Go back and listen to the other episodes. I’m pretty sure I talked about then, as well. But it’s something where it’s going to light you up. It’s going to challenge you. And to that; I’m like, good. Get mad. Get angry, and explore where those emotions are coming from. Because it’s something that; if you haven’t questioned this yet. If you haven’t gotten a little emotional about it yet, then I’m happy to facilitate you pausing and being like; wait a minute, is this actually right for me?

Diane Sanfilippo: We share that vibe. I have no problem disrupting someone’s emotional status quo and making them feel like they hate me for a minute, but then they actually come back and they’re like, thank for disrupting that pattern. Because that’s what ultimately leads to change. So, yeah.

Dr. Jolene Brighten: {laughs} My husband was saying to me a couple of weeks ago. He was like; I feel like if there was a band that’s the theme song for your life, it would be Rage Against the Machine.

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: {laughing} And I’m like; why, just raise your fist and march around? But in a way, because I want to disrupt the system. The system isn’t working for women and women’s medicine. And it’s something where I’m like; look. Before I die, I’m going to see women’s medicine do better for women. Because we get the short end of the stick in a lot of ways. It’s well documented. There’s medical gender bias. These things exist. And as women; we are the reason the human race is here. Those of us who do want to have babies, we’re very important to the existence of our entire species. So why aren’t we investing more in women?

6. What tests to run [32:50]

Diane Sanfilippo: For sure. And, what’s interesting is that perhaps initially, hormonal birth control contributed to more of the women’s movement and having this information and power to make those choices at the time. And I think there’s just a big backlash. Because now it’s actually disempowering women in a different way, because it’s disabling parts of our bodies that would have naturally been working.

Or, to your point about symptoms, we’ve hushed those signs of other problems, and now it’s kind of coming back with a vengeance when we do learn. Hey, maybe we don’t want to be taking these hormones in. And now we’re on the other side of problems, in a different way. So they don’t really solve all the problems that people want them to solve. And it may actually create more problems. It may create more issues than getting pregnant, and fertility, and all of that. So, I think it’s important for everyone to know that this is absolutely a feminist issue in a positive way.

So let’s kind of talk about a couple more questions people had on this. You mentioned briefly, a few minutes ago, about testing. What kinds of tests? Aside from symptoms, which are signs that something is not balanced. Which I think the skin symptoms are such a great one to pay attention to. And I love how you were explaining that the skin is like this; it’s the first place your body is going to go to just get rid of anything, because it’s not dangerous. Putting your heart in danger is a problem. But just popping acne on your face; not life threatening. Although it may be very upsetting.

Dr. Jolene Brighten: Yeah, it’s definitely something that I don’t want anyone to feel like I’m dismissing that.

Diane Sanfilippo: No not at all. They know.

Dr. Jolene Brighten: Ok good.

Diane Sanfilippo: Right, left, and center, we’re talking all about skin all the time on this show and other places. Because it’s been an issue for both Liz and myself over the years. And I’m at basically 40 now, when this show airs I will be 40. I feel like it’s finally getting to a good place. Which is wild.

But let’s talk about what are some tests that people can do to figure out what’s going on with their hormones, as they come off the pill.

Dr. Jolene Brighten: So when we go into testing, I do want to say with your symptoms, your symptoms have a lot of value. And what your experiences are in your body, every single day, has tons of value in it. So this is not something; I just want women to understand. I’m definitely in the tests don’t guess camp. But at the same time; those tests are a snapshot in time. Whereas the data of living in your body every day, that’s not something a lab test can tell me. Not a physical exam can tell me.

So it’s really important, because so often women will say; well my lab tests are normal, but I don’t feel normal. And it’s like; well did your doctor interpret your labs in the context of your symptoms? In the context of your story?

So with lab testing. If you are on hormonal contraceptives, one thing I do for every woman in my medical practice who is on hormonal contraceptives is I test factor II and factor V Leiden, which are genetic; if you have this genetic variation. Let me say it this way. You’ve got these two genes; if just one of those genes is primed to help you form clots. Not help you; but predisposes you, you’re at a 35-fold increased risk of having a blood clot. Which can lead to a stroke, to a pulmonary embolism, while you're taking an oral contraceptive. That’s some scary stuff.

And I have had a lot of women; this is something in the research. In doctor’s office. They’ll be like; “Well, I’m not going to test that, because it’s not that common.” I have seen this, and in that moment, I’m like; “Nope. You’ve got to stop this now. We have to have a plan to get off of it.” So, knowing your genetic predisposition to blood clot. Also heart attack and stroke. Looking at MTHFR is another thing to look at.

Now, whether or not you know those things, you can also look at inflammatory markers. And I have seen across the board, I have not yet to see a patient using hormonal contraceptives that does not have elevated inflammation. And it was something like many years ago when I started clinical practice that I observed my autoimmune thyroid patients.

So my Hashimoto’s patients, we couldn’t get their inflammation down. They weren’t healing at the same rate as my other patients when they were on birth control. And that was something their rheumatologist or their endocrinologist would say; “Oh that’s just because you have autoimmune disease.” But I’m like; why is it that one woman, I can help her get those antibodies in remission, her inflammation comes down. And with the other woman, it persists. We can’t heal her gut. What I was observing is they’d get about 80% better, and then we couldn’t really move the needle much further.

Once they transitioned off these hormones, they were like 110% better. And that was some of my early ah-has. And because I came from a research background, I was documenting all of these things and tracing them. And my husband would be like; “She was staying up all night.” Which is bad for your hormones. But reading about all of this. And my husband actually says; “It’s almost like you have a mental health disorder when it comes to why.” I get obsessed. I have to know why.

Diane Sanfilippo: Fixating.

Dr. Jolene Brighten: I will spend days, weeks on it. Yes! Where I’m like; no! There has to be a reason for this! I remember when I was in medical school, and I was like; I don’t believe in IBS. I don’t think that’s real. And thank goodness when we discovered SIBO and some of these other things going on, because people thought I was crazy then. But I’m like, no. That’s not a good enough why for me.

So let me go back to lab testing. We talked about inflammatory markers. That could be a CRP, so C-reactive protein that you're looking at. I like to look at that instead of ESR, which is your sed rate. I just find it’s more clinically useful. I also like to look at things like fibrinogen. Now, if fibrinogen goes high, you are at risk of a clot. So that’s another thing we can look at.

And then there are other markers like MPO, LP-PLA2. This is all alphabet soup for you guys. It basically tells me about your cardiovascular health. Is your immune system active in your arterial walls, in your blood vessels? Which is going to lead to plaque formation. That’s going to put you at higher risk of having a heart attack. Which does happen on contraceptives.

If you're a smoker or over 35, we are getting you off of these things. I’ll lab test, and I will have the conversation with women of; look. I get that you can’t get pregnant right now. But did you know, because most doctors don’t say, that over 35 you should not be on these hormones. Because you're at a higher risk for stroke and blood clots and heart attack. And that’s something that’s also important in our PCOS population, as well. Because; did your doctor tell you…

They put women on PCOS on hormones. And they’re like, “This will regulate your periods. But we forgot to mention; you really have a metabolic disorder. But because your acne and your periods are all fine, I’m not even going to worry about your diabetes or your heart disease.” And that to me is a huge disservice.

And then these women; it’s a lot of why we’re seeing millennials… I was actually in the New York Post. They reached out to me, and they were like; “We want to know why millennials are rejecting these hormones.” I’m like, because we were the tribute.

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: Our generation, and the generation before us was like the tribute.

Diane Sanfilippo: I volunteered as tribute?

Dr. Jolene Brighten: Right! It’s a really unique time in history where we’ve seen women suppressing their hormones for decades. I’ve had women come in who are like; I got my period, it was awful, so the next cycle my doctor put me on the pill. Here I am 30-something years later, I don’t even know who I am in my body. I don’t even know what’s a normal hormone state for me.” And that’s why I’m like; with post-birth control syndrome, it can depend. Because sometimes we don’t know what’s been going on for you. We don’t actually know what’s going on.

Now, other lab testing to consider, definitely monitoring adrenal health. If you're using these contraceptives, they are inflammatory, and your adrenal glands hate inflammation. They are like; “I’m going to come in, I’m going to protect you.” But only for so long. And if you're on a medication that’s depleting your nutrients, that’s going to impact your adrenal glands, your thyroid, really your entire body. So doing nutritional testing, I think, is important. Understanding your nutrient status.

And then also looking at a full thyroid panel. And understanding; TSH, what your brain says to your thyroid. Free T4, free T3. Interestingly, there are studies. People always love to come an argue with me and be like; no, actually there are studies that show birth control helps increase your thyroid hormone. And I’m like; ok, slow your roll on that noise. Because it is increasing your total thyroid hormones, that you can’t actually use. You use free thyroid hormones. And it’s doing that because it’s increasing your thyroid binding globulin. Oh, and by the way; it depletes all the nutrients that help thyroid conversion and actually gets that thyroid hormone on the receptor. Which is why your thyroid labs can look normal, but you are feeling exhausted. Your hair is falling out. Your skin is dry. You're constipated. All these symptoms. Because it is well recognized that any hormone can have cellular resistance. We always think about insulin, but the other thing that we can think about, too, is you might not actually be able to dock that hormone on the receptor site. We don’t have great ways to measure this in lab testing. So this is why your data is super, super important.

I can definitely keep going with tons of other lab testing we can do {laughs}. So simple things like a CBC and a ferritin to understand what is your iron status? And it gets really complicated. If the pill is affecting your thyroid, then your stomach acid is going down. The pill is actually causing burden to your gallbladder. Now you're not absorbing nutrients as well. Now we can see iron deficiency anemia. Fat soluble vitamins. How many women are like; “I get out in the sun, and I take my vitamin D, but I can’t get my levels up”? Well, are you absorbing fat? Have you asked that question yet?

Again, this gal, obsessed with the why’s. {laughs} I’m wanting to know what is actually going on for you. And then the other piece, just to say broadly about lab testing. Look at your insulin levels. Understand your insulin, your fasting glucose, your hemoglobin A1c. I even look at GSP, glycosylated serum proteins to tell me in the short term, what are you doing with that glucose? Because we know the birth control pill can actually induce insulin resistance.

So you may be finding yourself avoiding all the sugar in the world, and wondering, “Why am I still gaining weight? Why is it that I still have blood sugar issues?” And it’s like, have you questioned the birth control that you're using?

That’s why I brought up the whole feminist issue. Because your doctor is going to tiptoe on this, depending on what camp they’re in. They may not want to tell you that. And a lot of doctors; I’ve seen this. I’ve seen really smart, smart doctors. I’ve seen it all over the place where they’re like, “Yeah, but the side effect of getting pregnant. That risk is way to great. So forget the cancer. Forget the diabetes. Forget the stroke. All of that. Because getting pregnant is really expensive.” And I have a kid, it is really expensive. {laughs} It really is. And if you don’t want a kid, you need to have a reliable method.

So that’s just some of the things I’m looking at in terms of testing. Depending on your family history, we’re going to go deeper in other places. And we have to check your gut. And especially if you have a family history of autoimmune disease. If you're on a medication that disrupts your gut, then guess what? You are basically setting yourself up. These hormones could be a trigger, but it might be a situation where you're on these hormones, you're getting nutrient depleted, you’ve got leaky gut going on. You’ve got the genes for it. And you get into a car accident. And you didn’t see that coming. You couldn’t have prevented that. And now, you're starting to struggle. And your doctor is like; that’s not related. When it could be that now you’ve developed an autoimmune condition, just because you’ve got the perfect recipe going on.

7. Side effect-free birth control [45:24]

Diane Sanfilippo: Ok. So, two things I’m thinking. As I’m listening to you. One; are there any women for whom, aside from if it is a woman’s choice to take hormonal birth control. You're not going to say; no, you have to not take it. If she’s like; this is what I want to do with the information at hand, I hear from you, you’re going to let them make that choice, as long as it’s informed. However, is there anyone for whom it’s not detrimental to their body? It sounds like no. It sounds like basically that is the deal we make, basically. When it’s like; 99% sure we won’t get pregnant if we’re taking it effectively, as we’re supposed to. However,

Dr. Jolene Brighten: 91% with typical use. {laughs} They don’t tell you that!

Diane Sanfilippo: I would probably have said lower with how many times I would have forgotten it, although I was really more taking it to manage my period. At least initially. But yeah, is there anyone. Because they’re listening, right now. There are probably some women who are like; well, it wasn’t so bad before, and I’m really just taking it for birth control purposes. So I’ll stop when I want to have a baby. Is there anyone who is not being affected potentially negatively. And this is not a scare tactic approach. This is just what’s the real real, you know. Are all women being affected negatively by the pill?

Dr. Jolene Brighten: Yeah. Real talks; yes. It’s going to deplete your nutrients. It’s going to cause inflammation. All of these side effects are real. So the deal is, though; if you're on it, you need to take steps to protect yourself. I shudder, and I think; I know so many of your listeners are probably going to nod their head on this one. But when I started the pill, I was pulling up to fast-food windows, eating burgers and fries. And drinking my soda. {laughs}

Diane Sanfilippo: Oh yeah. We didn’t know. We didn’t know.

Dr. Jolene Brighten: We didn’t know. Oh man, the things. Again, let’s not judge or shame. I never want to be held accountable for what my 20-something-year-old self did, ever. So the short answer is no. If you're on these hormones, you're definitely being impacted. Now, does that mean that it’s this big ominous scary thing for you, particularly? Maybe. Maybe not. You can do the testing. And you can take steps to start safeguarding yourself.

So this is where I’m like; I find this really, really empowering. If you're on these hormones. And there are many things that you can do to start protecting yourself. This is what I wish my doctor would have told me. Because I did 10 years on the pill. I’m a first-generation college student. I went to medical school. Now I’m a doctor. I didn’t get pregnant by guys that I should have never been with in the first place.

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: We could do a whole podcast on that, of the pill and my bad boyfriends.

Diane Sanfilippo: And thank god for the pill in those moments, or whatever. Yeah.

Dr. Jolene Brighten: Oh my gosh! I’m so grateful for it.

Diane Sanfilippo: Not haters. Just, need to informers. {laughs}

Dr. Jolene Brighten: Totally! But, that’s the thing. And that’s really what my message is. If you’ve got to do this, then listen. There are some things that you can do to protect yourself. And you have to know that you don’t get a hall pass for binge drinking. You don’t get a hall pass; nobody gets a hall pass for binge drinking, let me just say that. But you can’t be basically all of the things that we know we should be doing because that’s just what humans need. You need to be doing. You have to be eating a whole foods diet. You can’t be going out there and partying all not and not sleeping.

And I say this because; who gets put on the birth control pills? Women who have conditions. They present with hormonal symptoms. But also, it is definitely part of the college, off to college package. And this was something, when I sat in… In medical school I did a lot of rotations with conventional medical doctors. Because I was like; I want to be integrative. I want to understand the full spectrum here. And I remember the little pill book that they would pull out every time when a girl would say; I’m getting ready to go to college. I want to have my physical. And they’d be like; ok, this is the pill you need to start, because you're going to college.

Ok, great. But she’s going to go to college and she’s going to eat dorm food now. Have you talked to her about maybe she needs some leafy green vegetables in there? And I work with girls who go to college. And that is a real struggle, when you don’t have a kitchen and you're relying on the food.

Thank goodness; it’s so different now, in terms of you can get green powders. You can get paleo bone broth based anything these days. Bars and powders and all kinds of stuff. There are so many things. It’s kind of like the whole gluten free movement. When I went gluten free it was like; if you want to eat bread, you can have this rock-hard roll, and its nasty.

Diane Sanfilippo: Gross. Yeah.

Dr. Jolene Brighten: It was so gross! And now when people are like; “I don’t know how I’m going to go gluten free. It’s so hard! There are no options!” I’m like, let me tell you. {laughing} Let me tell you about no options!

So it’s a situation where I think this needs to be part of the parquet. And parquet; in medicine, if we give you a medication or any treatment, we have to go over that with you. We have to tell you about alternatives. We have to answer all of your questions. This is not your doctor’s fault in a way where it’s like; if they’ve got 7 minutes in a visit, how do you cram all of that in? That’s why I’m here, I'm talking about this. So you can get in the know on all of these things.

But it’s also a situation where teenage girls; we saw a research study come out where teenage girls were at three times the suicide risk in the first few months of using hormonal contraceptives. Oh. My. Gosh. When I read that, I freaked out! And I was like; whoa! I remember when I took, there was a pill I took. I wish I would have documented all this stuff. But what did I know; I was 19.

But I took a pill, and I remember just sitting in the shower crying. Just sitting in the bathtub, just crying. And I feel like that was a week of my life. And my doctor was like; “No, that’s not what’s going on. But let’s switch your pill, and let’s just see if it helps.” And it did. Man, what I wish I would have known then. But this is a situation where your doctor should let you know; if you get depressed. I mean, there was a study showing that 20% of women who start the pill have anxiety.

I had a patient who; you may have heard me talk about this girl who went to college, developed anxiety, went into panic attacks, and it was all after starting the birth control pills. And then she stopped it abruptly, and none of that went away until she started to work with me and implement some of my protocols. But she was failing out of college because she had test taking anxiety now; something she had never had. And she was gaining weight, and her doctor was like, “That’s just the freshman 15.”

Diane Sanfilippo: {laughs}

Dr. Jolene Brighten: Can we stop that? Can we stop just being like, “Oh, that’s just this thing we say.” It’s like; having a baby. So go back and listen to those episodes. “Oh, that’s just being a mom.” Maybe. And this is the thing, ladies. Your doctors are really smart. They’re really smart. So challenge them. Challenge them to think a little bit more about it.

So the other thing I’ll say about the depression and the suicide risk. It gets a little bit scary to me. And I don’t know the answer. Because I ain’t got all the answers with this stuff. But women can get on these hormones without talking to their parents. Without their mom knowing about this. So it’s something that I tell young girls that are in my practice; and young girls who are listening. If your parents; I had super religious parents. They would have flipped their lid if I’d gotten on the pill when I lived in their house.

And if that’s your situation, and you're getting on the pill or any of these hormones and you don’t want your parents to know, at least let a girlfriend know. Let somebody know, so that they can keep tabs on you. Because the people you hang out with every day, they’re going to notice if you're not coming out to play anymore. You are lacking joy and motivation. These are things that can be signs that these hormones are not working for you. And they can lead to mental health issues.

So with all of that, I think these are the conversations doctors should be having. If you're going to write that prescription, let girls know. And women; I don’t know. If we’re having a period, maybe I shouldn’t call us girls. I still call myself a girl. And I’m almost 40, so there’s that. We should have that conversation, and we should talk to them about, what should you look out for? And given your family history, here are some signs.

I had a patient come into me. She had a DVT. So she got a clot in her calf while she was on the pill. And she didn’t know what it was. She was walking around for like a week until it got so painful. So her doctor hadn’t given her a heads up of; this is what it looks like to get a clot. And then he put her on the patch. And I was like; no, no, no, no. And I’m like; let’s get a cardiologist in on this, as well. Because you have these risk factors. And her cardiologist was like; absolutely not. No, no patch for you. And it was a situation where she actually had a genetic mutation where it’s like; oh, look. You are at a higher risk for having a clot as it is, so this isn’t going to work for you.

Diane Sanfilippo: Oh, it’s so interesting. Just because people will prescribe it quickly, or think it’s no big deal, doesn’t mean that that’s true. And you know, I think with our audience. And this was true of myself. And it’s true of myself anytime I’m feeling a certain way that’s other than in balance, or happy, or healthy, or anything. It’s a matter of getting back to baseline before we try and needle at different minutia. So my point being; when you're dealing with something like acne, or moods that are one way or another, or autoimmunity. Literally any kind of imbalance that’s going on with your body.

If you're not sleeping. If you're not eating well. If you are taking some kind of medication or hormone that’s not something, for example, a thyroid hormone when your thyroid is not making it. You need that to get to baseline, so that’s bringing you to baseline if you need it. So I never want people who are taking thyroid hormone because of their thyroid to feel like that’s medication they shouldn’t be taking. I’m talking about something that up or downregulates a normal body function. Not brings it back to normal.

So if you are doing anything. If there’s any kind of input that’s pushing your body away from baseline, whether it’s hormonal birth control. Caffeine, sugar, alcohol. So caffeine going up, alcohol suppressing and depressing our system. Any of those things; that’s where we need to start stripping away to just let our body be at it’s optimal place. And then we can look at; ok, what are those tests saying.

In the situation I’m in all the time; it’s like, am I sleeping? Before I go get some blood work done. Am I doing the things that I know I’ll need to do to get my body healthy? Because what good is all that blood work if what I’m doing is a bunch of things that I know are stressing me out or pulling me down or any of that.

I just hear this as; if you're trying to figure out what’s going on with your body, and you're taking hormonal birth control, it’s something to strongly consider getting that stimulus out of the system and working with a practitioner so that you can figure out what is going on with your body. Because while that hormone is there, and all of the side effects that come with it. Or set of hormones; it’s not just one hormone. But while that’s there, it’s really hard to know what your body will do given any sort of input. Because you're not at a baseline.

I just think it’s an interesting phenomenon where we just have been very flippant about it in the past. Very quick to prescribe, quick to take. Not quick to question, that’s for sure. I definitely wasn’t questioning. And I was just taking it. Really just taking it. Anyway. It’s crazy to think about all those years. but yeah.

Dr. Jolene Brighten: Well, you’ll notice no where in the lab testing did I say test your sex hormones. Because it’s not going to tell you a whole lot. And I think you make a really important point there, and that is; how do you know what is normal for you if you are currently suppressing your sex hormones? And to your point, it’s really funny that you're like; “Why am I going to get that lab testing if I’m not sleeping.” You’ve written books. I’m writing a book. I skipped my DUTCH testing. I was like; nope, not going to do that right now. Because I know my stress is higher. I know what it’s going to say. And I know what I need to be doing differently.

So I think it’s a really important point to make that if you are not doing the foundational things; like sleeping, eating, exercising. It’s not sexy. It’s not glamorous. But hello; you're a human. This is what you have to do! It’s not optional. But if you're not doing those things, it’s going to be hard to get an accurate measurement of; what would you be like if you were doing those things.

Diane Sanfilippo: Yeah. The basic diet and lifestyle stuff. Things are covered in the books that many of us have written over the years. Will take you 80% of the way before you ever start working with a practitioner if you do it. And you give it several months because you're going to show up, and they’re going to say; do this first. Anyway, whole different topic.

Ok, I think we covered. There was another kind of general question about how these other factors affect recovery, and I think you touched on that well enough. It’s all over the board in terms of how long it can take and how different things will affect recovery. Or how going off the pill will affect other issues improving, perhaps. Like gut imbalances. Like thyroid issues. All of that. So it is all tied together, and it’s totally unique for everyone.

Dr. Jolene Brighten: I’ll also say, too. There are benefits to stopping these hormones. They could cause chronic yeast infections. Those could go away. Your libido can come back! Wohoo! {laughs}

Diane Sanfilippo: Isn’t that a kicker?

Dr. Jolene Brighten: Oh man. Your libido. Because I have women who are like; I’m going to stay on these hormones, but I want to get my libido back. And I’m like; I hate to break it to you, but clinically, I’ve seen that’s impossible to do. Because what they’re doing is suppressing all of those hormones. And it’s such a sad thing to me.

Diane Sanfilippo: I think that happened to me when I was younger. I’m pretty sure.

Dr. Jolene Brighten: I didn’t have a libido through my 20s. I’m like; you know what. When I got off of these hormones, and I started having 30-something orgasms, I’m like; what is this?!

Diane Sanfilippo: Yeah.

Dr. Jolene Brighten: Why didn’t somebody tell me this could exist in my world! It’s amazing.

Diane Sanfilippo: That’s terrible though. Man!

Dr. Jolene Brighten: It is. But it’s a really, really great way to prevent babies. Let’s just be real about that. If you don’t even want to be touched, there’s that! {laughs}

8. Sleep disruptions and hormone balance [1:00:46]

Diane Sanfilippo: Wild. Oh my gosh. Ok, so let’s see. There’s one question here that I think would be interesting about sleep. We were talking about that a bit. This one was from Amelia, who I actually know quite well. She’s one of our sugar detox coaches. And she’s actually on my Beautycounter team. So she is hooked in on all this stuff. She’s asking, “Is sleep the link we could be overlooking in regards to regaining a menstrual cycle? So much happens while we sleep, and many of us working women, some moms, have issues balancing our hormones either to get a period or to have a baby or to regain it post baby. Then we add in sleep deprivation, too much sleep deficit, etc.”

She’s asking about that as related to cortisol and circadian rhythm health, all of the issues that come along with that, and all of the other hormones too, like serotonin and gut health effects. So where do you see that; sleep being this missing link when we’re; I would say post-birth control. Where does that fall?

Dr. Jolene Brighten: Yeah. We do a lot of work with circadian rhythm to reestablish the hormonal connection. So, there are studies that have come out showing; and there’s a great one on the liver. That the liver actually doesn’t detox appropriately when you're missing sleep. So Chinese medicine had it right forever ago, that our organs are on clocks. We’re all on a clock. And the circadian rhythm is really important. Especially when you consider as women, we’re really synced up with the moon. I mean, our cycles will sync up with the moon. And it makes sense.

I need more studies. I definitely want to nerd out on this one a lot more of; ok, scientifically, what’s going on. Well, the moon does govern the ocean, the bodies of water. Your period; that’s water. And I think there are things way beyond what we can see in the sky, that we’re syncing with as women.

So with sleep, absolutely. If you are missing sleep, then you're not getting your growth hormone up. You're not repairing tissues. If your cortisol is up at night, then your melatonin is going to be down. Melatonin, which by the way if you're on these hormones, or you have a family history of estrogen cancers or really cancer of women’s reproductive system or breast, you need melatonin.

There have been studies on nurses, night shift workers. Thank goodness for them. Let’s just take a moment to honor that there are women who are willing to work these night shifts. But they’ve been studied, and they find that they have higher risks of breast cancer. And they believe it’s because their melatonin levels are low.

So, what can this tell us? If your liver is not detoxifying, what chance do you stand on balancing your hormones ever? And in addition to that, you're not getting healthy other hormones up. Like melatonin. And that’s going to affect brain health. What do these hormones do? They shut down your brain from talking to your ovaries. It’s huge. I see a lot of people coming on; and I love that the conversation around post-birth control syndrome is starting to pick up steam. I feel like I’ve been shouting about it for 5 years now; probably longer than that. And now to see it.

But the thing is, everybody is focused on; we have to get the sex hormones and focus on that. Well what about your brain health? Your brain health is really important in all of this, which is tied to your gut. But also tied to your sleep overall. So I think this is a phenomenal question, because I absolutely see that hormone imbalances are tied to sleep disturbance.

And I know she threw in the mom caveat in there, and call it the mom curve. What we see for cortisone. That is, a small human whose liver wasn’t developed; it’s not their fault. They need to eat at night. Trained you, and your cortisol, and your stress hormones, to go up at night. And then your cortisol is down during the day. That’s the opposite of what it should be. So this can be something; you can come back from this. You do have to work on it. But sleep hygiene; that’s a non-negotiable in my clinic. I’m like; you have to be caring for your sleep. And you cannot be exposing yourself to light at night.

We’re at a point; we’ve got more than enough evidence about that. This is just another form of pollution that is very unique to the new human experience, evolutionarily speaking. We did not evolve with street lamps coming in at us at all hours of the night. So you’ve got to sleep in a completely dark room. You need to rock some amber glasses, ok. And there are super cute ones out there. Not to dis Dave. I love Dave Asprey. But I don’t like the way those glasses look on me. So I’m vain enough with that. You can go on Amazon and you can find cute amber glasses, rock those.

I even have women doing things like going by candle light one week. At least one day out of the week if they can. This is something; my husband was traveling. And we had no sleep issues going on with my kid. Which, he’s 5. And I’m not bragging. My kid didn’t sleep forever. It’s why I have one. And I tell him that. I’m like; “you would have a sibling, but I didn’t sleep and I learned I have to have sleep. This is really important for me. I break down. I’m not a whole human without that.”

So my husband was traveling. And he was like; what did you do differently while I was gone that you had no problems with bedtime? I’m like, when he got home, I was pulling all the curtains and it was candle light only. No lights on at all. And this is just something; it allows your melatonin to naturally rise.

What happens when light comes in; it comes through your eyes. It hits the pineal gland. And the pineal gland starts to break down your melatonin. If you get up in the middle of the night to use the restroom; with a baby, red head lamp. That’s my little trick. I would actually have a head lamp with a red light on only. I think pink Himalayan salt lamps can be nice if you do need some light. Because stubbing your toes, or getting a head injury in the middle of the night is real and nobody wants that. But you’ve got to minimize that light exposure, otherwise it starts degrading that melatonin.

And the other thing I’ll say is that; that’s really important for fertility, as well. But if you are night waking, you also have to look at your blood sugar. Because that’s all linked in, as well. And this is something; women will say, I’m waking up in the middle of the night and I’m feeling hot and sweaty and I think I’m having hot flashes and I’m 32. I’m like; what did you eat for dinner? “Oh, I ate a salad.” Yeah, I think you probably need a little bit more than that. That can be as simple as nick some collagen into some tea and drink that two hours before bed, and get some amino acids going. Maybe you need a little more carbs at night with that.

I know I kind of go off here. But my long-winded way of saying; yes ladies. You have to sleep. You have to be sleeping. And absolutely, that is one of the foundational things that I do in post-birth control syndrome. I’m like; we’ve got to safeguard the circadian rhythm. Because again; all of our organs are on rhythm. They’re all going on rhythms. There are studies out there to support this.

Mad props to Chinese medicine; this is the thing I always love. When you see conventional medicine dismiss something; dismiss something. And then a study comes out; and this is the thing. A lot of the time, a study comes out and they’re like; “oh yeah, we were saying that all along. We always knew that.” I’m like; hold up. You were totally bagging on those Chinese medicine docs, and it turns out there’s a wisdom to the body, and just making observations. We don’t always have to have a study to support. I just think it’s kind of silly at this point.

We need another study to support that you need to sleep? What happens if you don’t sleep? That’s how they break people down mentally, ok. That’s a form of torture. And if you know that’s a form of torture, a legit form of torture, people, then what are you doing to yourself?

Diane Sanfilippo: Yes! Amen. And you know, I love how impactful it is. Liz actually talked about this many years ago on our podcast when; it’s always when the husbands are away that someone does a sleep experiment.

Dr. Jolene Brighten: That’s so true.

Diane Sanfilippo: So her husband is/was military. So he was away for a while; maybe 30 days or something, deployed. And this was before she had a kid. And she did the whole; sunlight is gone. I don’t turn lights on. Candlelight only. Keep it dark. And had the best sleep ever for that whole month.

I think; I definitely see this in practice with myself. If I set my little Fitbit alarm to tell me to get ready for bed early, and I really start that process early and I keep only the lowest lights possible on in the house. Not even to the level of candlelight, which is a great take it all the way there. But I see the benefit even just keeping the lights down. The lights in our lamps in the bedroom are a little bit more orange than regular lights, and they’re very, very dim. So if I just keep that on.

I’ll even sometimes shower quasi in the dark just to keep it dark. That whole process, for at least about an hour before bedtime, it really does get me prepared to sleep so much better. And I definitely struggle with sleep. But lately its’ been so much better. I put something on, audio. I have to listen to something so that my brain turns off. That’s a struggle of mine. But, I probably get about 30 seconds to a minute into the audio before I fall asleep. And it just gives me that peace of mind. But it helps so much to get my body starting to calm down for so much longer.

And I love that you mentioned how the light, and probably more particularly that blue light, just the white blue light, what it does is activate the pineal gland. Which tells melatonin to slow down. Because that makes sense to everyone. Obviously, when the sun comes up, melatonin goes down, cortisol rises. And that’s what wakes us up. So when we’re doing that and disturbing that process naturally. That’s normal, in the morning, we disturb that process so we can wake up. But overnight, if it’s bright lights all the time.

I think that was a great tip too, for moms. How can they do what they need to do as a mom and feed the baby, but also try and keep that blue light from coming into play. For sure. So it’s so important.

Dr. Jolene Brighten: Yeah. And if you think about it just with nature. This is why I’m like; you don’t have to have a medical degree, you just have to pay attention.

Diane Sanfilippo: And try it.

Dr. Jolene Brighten: Yeah. But when do we see this blue light spectrum in nature? When the sun is rising in the early day. When do we see it now as modern humans? Every time we’re on our cell phone. On our computer. And that’s the other thing, too. I love you scrolling my Instagram before bedtime. I get most of my messages at that. I love that. Just rock some amber glasses while you're doing it. Make sure you have some amber glasses on. And if you are on anybody’s page or doing anything…

Diane Sanfilippo: Put it on Nightshift.

Dr. Jolene Brighten: Yeah! Nightshift as well. We’re chatting right now; people don’t know that we can see each other. But I have my Nightshift on right now. I joke, it’s the most indulgent thing when I have Nightshift on and my amber glasses. And my brain is like; oh, this is so nice.

Diane Sanfilippo: So much calmer. Liz did an interesting experiment with her toddler sometime last year I think. I’m going to have her jot down those notes, or maybe I’ll send them to you. Because she didn’t have the best experience with using the orange lights before bedtime. Her kid, I think, ended up just waking up earlier. Because it tricked her brain to thinking she was asleep, or starting to go to sleep earlier.

So it actually ended up kind of; I think it’s a little different for us as adults where it’s like; we are not going to go to sleep just because the sun is down. We are going to finish doing some things. So, I can see the benefit to having them on while we’re still just getting things dealt with. But then the extension of staying up with them isn’t actually probably giving us the benefit that we think. Do you know what I mean?

We can wear them to help, but if we are trying to have that make up for sleep, we’re not doing it. Which I know that’s not what you're saying at all. But it was interesting when she said that had happened. She said, actually trying to fake making it darker had her kid; her kid’s body responded to that, but didn’t actually get the sleep. She just woke up earlier. So I thought that was interesting.

Dr. Jolene Brighten: That is really interesting. I’ve definitely seen that if I do that with my kid and he ends up falling asleep earlier, then he’s waking up earlier. His little clock is like; I’m going to sleep 12 hours. And if I fall asleep at 5, guess what?!

Diane Sanfilippo: Yeah, 12 hours.

Dr. Jolene Brighten: I know. I wish.

Diane Sanfilippo: That’s interesting. It’s so interesting. Ok. So this is, I think the last question. Because we’ve said we could book multiple days and just have a conversation. But we will definitely bring you back. I think it will be really fun. We’ll come up with some creative ideas here. But seed cycling. I’m curious about this, because I heard about it probably almost a decade ago when I was first learning about a lot of things surrounding nutrition and hormones through the Chek Institute and holistic practitioners with that. Really, looping this in on what that does for our hormones as women. And I think anyone who has been watching you on Instagram, you're talking about it a little bit.

Why don’t you talk about your experience, why you’re doing it, what it is, what it does? And what about people who can’t eat seeds?

Dr. Jolene Brighten: Yeah. I saw that question. So, let me back up and think where to start here. Seed cycling. The first thing I’ll say is that this is naturopathic medicine 101. Our first year where we’re sitting there learning about pathological, gynecological diseases, we’re getting taught about seed cycling. So there’s been a wisdom to this for a long time. And a lot of women have been doing seed cycling as well.

What we now understand, and the research, is that; yes. These seeds, at the right time of the month, can impact your menstrual cycle. So seed cycling, this is how it works. Days 1 through 14, we’re doing flaxseeds and pumpkin seeds. Or; sometimes I don’t do both of them. Those flaxseeds get really controversial because women will say; oh, wait, that’s pro-estrogen and I’m going to have estrogen problems. Well, you should have estrogen higher. You’ve got to understand how a menstrual cycle works. Estrogen, she’s the queen in the first half of the cycle. She spikes and that’s why you ovulate.

What research has shown though is that the lignans in flaxseed; this is different than flax oil. Flax oil has been shown in research to have issues. And they’ve done studies with men and prostate cancer. Because that can definitely be an issue with that. But flax oil is usually oxidized. It’s something that you can’t; this is why we have to fresh grind these flaxseeds. Because these really beneficial oils; oxygen messes with them.

So when I’m talking about this, we’re talking about whole seeds. And no, you can’t buy the bag of preground. What you can do; this is my hack. I grind a weeks’ worth, and I stick it in the freezer, and then I just pull it out. I also just keep a coffee grinder there, and I just throw the seeds in, and grind it up, and throw it on whatever.

So with flaxseeds, it’s not just about the oil. There’s lignans in there. Those are a group of phytochemicals. They have weak estrogenic properties, but also weak anti-estrogenic properties. Which is why it can help balance that estrogen out. There have been studies showing, as well; there has been some conflicting studies. Which there are always conflicting studies. But there have been studies showing that these fresh ground flaxseeds can also start to elevate your sex hormone binding globulin. And not in the way that birth control does. But in a way where it keeps your estrogen and testosterone in check.

Testosterone is going to rise before you ovulate, because ladies; nature wants you to get knocked up. So let’s give you a libido! So that’s the other reason the flaxseeds can help, so that testosterone doesn’t get too high. And then pumpkin seeds being rich in zinc and other oils, they can also help balance out that estrogen and testosterone.

Then, in the second half of the cycle. So that’s days 15 through 28, that’s when we’re going to use sesame seeds or sunflower seeds. And with those, same thing with the nutrient content. And so things like zinc, and vitamin E can stimulate progesterone production, as well. And that’s what we’re aiming to do; stimulate the progesterone production in the second half of the cycle. Because now she’s the diva that should be rocking that phase.

So, with that; women who are listening and they’re like; wait a minute. I don’t have a cycle at all; what do I do with this? That’s when we say, go day 1 through 14 is new moon to full moon. Now, there is nothing wrong with you if your period comes on the full moon. I just want to say that. Because every time I post about moon cycle, women are like; “{gasp} Does that mean I can’t get pregnant, or I’m broken?” Your body is super wise. And not all of us are directly on the full moon. Some of us are waxing and waning. This is a whole nother podcast for another day, I’m sure.

So with that, we go new moon to full moon. That’s going to be your flaxseeds and your pumpkin seeds. Then full moon; because you should be full with pregnancy, and you think; moon’s out, what else are you going to do but have sex? Because you were living in a cave. What else are you going to do? There are scary things that will eat you out there! So from full moon; I crack myself up sometimes.

From full moon to that new moon again, that’s when we’re going to do the sesame seeds and the sunflower seeds. If you watch my Instagram, you’ll see I love the pumpkin seeds and the sunflower seeds. I just grab a handful. They’ve got to be raw. I throw them in my mouth and I chew them up. Again; lazy. I’m like, whatever is easiest for me.

And if it’s flaxseed or sesame seeds, you're going to need to grind those. Just get a coffee grinder. Don’t even waste your money on a burr grinder. Just get a cheap coffee grinder, it will work just fine. But don’t grind your coffee in it, too. Because then it’s just going to be funky all around. You're not going to want to eat anything, drink anything with that. Does that help in terms of understanding seed cycling?

Diane Sanfilippo: Yes.

Dr. Jolene Brighten: One thing I want to say. With seed cycling, I’ve used this a lot in my practice. And I was like; I think this helps. It’s just a piece of the equation. I had a PCOS woman come to me. She was struggling with getting pregnant. And she was following a paleo diet. She was exercising. She was sleeping. She was already doing all of these foundational things. So that’s the first thing I want everyone to understand.

I was like; let’s start with some seed cycling. Let’s get that going, and lets run some lab testing. And the next month, she missed her appointment, and I was like; what’s going on? And I get this message where she’s like; I’m pregnant. I got pregnant after not being able to get pregnant for years.

Diane Sanfilippo: Wild.

Dr. Jolene Brighten: And that was something that I was like; in that moment, I’m like; ok. Now I’m really a believer.

Diane Sanfilippo: Yeah.

Dr. Jolene Brighten: Because I wasn’t taught that could happen. That is crazy! I’m like, what did you do different? She’s like, I just started seed cycling. Again, this was somebody who was already doing the foundational things. So don’t think you can skip your sleep, or binge on anything you shouldn’t be. And you know about that. And then just seed cycle your way out of it.

Diane Sanfilippo: Right.

Dr. Jolene Brighten: You can’t do that.

Diane Sanfilippo: That’s amazing though.

Dr. Jolene Brighten: I was just going to speak to the autoimmune paleo question. Do you want me to talk about that?

Diane Sanfilippo: Yes.

Dr. Jolene Brighten: Yeah. So I think you and I; we share a similar philosophy on this. Autoimmune paleo is a therapeutic diet. And when you're using a therapeutic diet, that translates to temporary. It’s supposed to be a means of actually eliminating your foods, and then reintroducing them and seeing; is that true for you?

Now, we’re talking about four different seeds right now. Are you reacting to all of those seeds, or are you only reacting to some of those seeds? You have to ask these questions and test it out and see what’s true for you.

These seeds, from these seeds an entire organism grows. So they’re pretty nutrient dense. And to me; I’m like, you're missing out on some really good stuff if you can never eat seeds. But maybe it’s true for you. Maybe you’re like; nope. I’ve tried it. I would say; can you heal your gut and do some other things and maybe get back to those. But if you can’t do the seeds, you can actually go with some oils instead.

You can use fish oil; it must be a high quality. If it comes in bulk, it is oxidized. It is junk. If it’s not third-party tested, which means somebody who has no financial interest in this product is testing it to say that it’s legit. If it’s not third party tested, I wouldn’t touch it. If they’re not screening for things like heavy metals, PCBs, all this junk that you don’t want in your fish oil, don’t touch it. It’s not good.

This is when women are like; I did the fish oil and I didn’t get better. And then they’re like; I went and picked it up at a box store. {laughs}

Diane Sanfilippo: I wont touch fish oil with a 10-foot pole, personally, because I just don’t trust any of it. I will eat fish until I’m blue in the face. {laughs}

Dr. Jolene Brighten: Yeah, that’s also something we’ll do. We’ll go really highly loaded omega-3 fatty acids. Again, we’re talking if we can do seeds, nuts, anything like that. Then eating the fish. So first half of the cycle, you can use the fish oil. So you're going higher in omega-3s. Second half of the cycle, you're using evening primrose oil. So you can actually cycle them that way. There are a lot of things we can use to cycle. But if you're like; that’s a hard no for me on the seeds. Or you’re currently doing the autoimmune paleo and you don’t know yet, you can actually go to the oils.

And like you said, you could do food-based. So getting sardines in. And no, what is this thing with people being like; ew sardines and anchovies! I’m like, yeah, somebody on TV made that popular to joke about it. Have you ever put them in your mouth? Because I remember the first time I had sardines. I was like; these are going to be gross.

Diane Sanfilippo: They’re not that different from tuna. They’re just smaller.

Dr. Jolene Brighten: They’re super good! Oh my gosh. But eating those rich omega-3 fatty acids. and doing that a little bit more in the first half of your cycle. It doesn’t always have to be a supplement. In fact, I’d say always start with the food first. If you are trying to out-supplement your diet, that’s not going to work. With birth control, you can’t out diet birth control. You have to be doing the diet and you need to be using the supplements, just because it’s depleting those nutrients.

Diane Sanfilippo: And a very quick follow up on this. If you are doing it in seed form, what kind of quantity? A tablespoon a day? Two tablespoons? And whole versus ground? How much are we talking?

Dr. Jolene Brighten: Yeah. I usually say about two tablespoons.

Diane Sanfilippo: Ground?

Dr. Jolene Brighten: Fresh ground, yes. And again, if it’s pumpkin seeds or the sunflower seeds, they need to be raw. Everything needs to be raw. Because once it’s cooked those oils are destroyed. But that’s something; I don’t even grind it. I just throw it in my mouth and I chew it until nothing is left. So that’s like 30-something chews, you guys. Not like; oh, I chewed it twice. It’s because you're breaking it down. Which; we know. Digestion starts way before it hits your stomach.

And then when it’s the flaxseeds and the sesame seeds, those need to be fresh ground. And like I said, you can grind them up and then you can throw them in the freezer to prevent the oxidation.

Diane Sanfilippo: I love that idea.

Dr. Jolene Brighten: Yeah. So at least two tablespoons. And I like to say, do two tablespoons of each. And if you watch my Instagram; people are like, “I struggle with this. How do you possibly do this?”

Diane Sanfilippo: Just throw it on a salad. I don’t know.

Dr. Jolene Brighten: Yeah. Just throw it in things. I have patients that are like; I just throw the flaxseeds. I grind them, throw them in my mouth, and chug it with water. I’m like; that’s hardcore. Cool. Do it. More power to you.

Diane Sanfilippo: That’s an interesting approach. Yeah. I would easily throw that on a salad, no problem. Awesome. I mean, that’s super practical, easy to do, affordable for pretty much anyone. So I love that.

So, not surprisingly, there are plenty of questions we couldn’t get to today. But, we will save them, you guys. We know that you have so many more questions. And you love hearing from Dr. Jolene Brighten. So we’ll definitely have you back on the show sooner than later. But I think that’s all we have time for today. We really sucked up a lot of your time. But thank you so much for spending that time.

Dr. Jolene Brighten: This was enjoyed. Don’t even say that.

Diane Sanfilippo: {laughs} Ok, so we already talked about your Instagram, which is at Dr. Jolene Brighten. But where else can people find information from you around the interwebs?

Dr. Jolene Brighten: Yeah. So I love writing. You’ll find a lot of information on my website, which is DrBrighten.com. a little tricky, because it’s Brighten like the sun, not like the jewelry, if you know what I’m talking about with that. It’s B-R-I-G-H-T-E-N. And for those of you listening that are like; I need more information about post-birth control syndrome and all of that, you can go to DrBrighten.com/pill and I’ve got a free Master Class. It’s about 90 minutes long. So you can always go back and rewatch it. But it’s a free class that you can go through and really educate yourself and understand what’s happening in your body, and what are some things that you can do to actually reverse all of this.

Diane Sanfilippo: Awesome. I love that. We will link to that in our show notes, as well. So if you're on the blog, and you're kind of checking it out and you forgot that you didn’t check it out when you wanted to because you’re commuting or whatever, we’ll definitely link to that so you guys can get to that all.

Thank you so much. I have so enjoyed talking with you today. I can’t wait to chat with you again.

Dr. Jolene Brighten: I’m looking forward to it, yeah!

Diane Sanfilippo: So until next time.

Dr. Jolene Brighten: Thank you!

Liz Wolfe: Today’s podcast is sponsored by Vital Choice wild seafood and organics. The leading source of high quality, sustainably sourced seafood and a certified B corporation. Spring has sprung, and it’s time for light but powerful paleo-friendly fare. Like omega-3 rich wild seafood and delicious grass-fed meat. For something easy on the go, grab one of their tins of sardines, or some salmon or bison jerky. They’ve got our favorite wild salmon and shellfish; plus salmon burgers, dogs, bacon, and even organic bone broths. Check it all out at www.vitalchoice.com.

Diane Sanfilippo: Alright you guys, that’s it for this week. You can find me, Diane, at http://dianesanfilippo.com. And Dr. Jolene Brighten at DrBrighten.com as she mentioned it’s D-R-B-R-I-G-H-T-E-N. Join our email lists for free goodies and updates you don’t find anywhere else on our websites or on the podcast. And hey; while you’re on the internet, please leave us an iTunes review. It really helps new people find our show. We’ll see you next week.

Podcast Episode #347: Female Hormones & Recovering from Birth Control with Dr. Jolene Brighten

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